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DR. STACEY LOUISE DAULT DO
NPI 1760775357
Family Medicine - Sports Medicine in Tempe, AZ

Active since May 16, 2011PECOS EnrolledAccepts Medicare Assignment
6139 S RURAL RD STE 102, TEMPE, AZ 85283(480) 846-0688(480) 741-8650 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 7, 2026, Apr 9, 2024, Dec 6, 2022 and 3 more (6 updates tracked since 2022).

About Dr. Stacey Louise Dault Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. STACEY LOUISE DAULT DO (NPI 1760775357) is an individual sports medicine provider in Tempe, Arizona, licensed in Arizona (006185) and active in the NPI registry since May 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Arizona College Of Osteopathic Medicine Mid Western University (2011).

NPPES Registry Identity

NPI1760775357
Entity TypeIndividualFemale
Primary Taxonomy207QS0010X
Provider Legal NameDR. STACEY LOUISE DAULTCredential: DO
Location Address6139 S RURAL RD STE 102Tempe, AZ 85283-2929
Mailing AddressPo Box 6085Chandler, AZ 85246-6085 · (480) 846-0688 · Fax (480) 741-8650
Phone(480) 846-0688
Fax(480) 741-8650
Sole ProprietorNo
Medical School CMSArizona College Of Osteopathic Medicine Mid Western UniversityGraduated 2011
Enumeration DateMay 16, 2011
Last NPPES UpdateMay 7, 20266 updates tracked since enumeration
NPPES CertifiedMay 7, 2026
✔ NPI 1760775357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in AZ · 006185
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
6139 S RURAL RD STE 102, Tempe, AZ 85283
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Other Names 1

Former Name (1)Dr. Stacey Louise Wetmore Do

Secondary Practice Location 1

Location 122044 N 44th St Ste 120Phoenix, AZ 85050-6103 · Phone (480) 846-0688 · Fax (480) 741-8650

Other Identifiers 1

Medicaid030026AZ

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Stacey Louise Dault Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759503980
PECOS Enrollment IDI20160115000512
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Stacey Dault reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Achieve More Sports And Wellness, PLLC
Same address
Primary Care
6139 S RURAL RD STE 102
Tempe, AZ 85283
  • Reassigned Medicare billing, Arizona enrollment
NPI 1558012021 (480) 846-0688
Modern Sports Medicine LLC
2.4 mi
Sports Medicine
1840 E WARNER RD STE 121
Tempe, AZ 85284
  • Reassigned Medicare billing, Arizona enrollment
  • 48 clinicians in this Medicare group
NPI 1366116535 (480) 306-6627
Scottsdale Health And Wellness PC
13 mi
Family Medicine
8630 E VIA DE VENTURA STE 105
Scottsdale, AZ 85258
  • Reassigned Medicare billing, Arizona enrollment
  • 2 clinicians in this Medicare group
NPI 1912903527 (480) 889-1838

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
239 services69 patients
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose J7321
Hyaluronan or derivatives like Hyalgan, Supartz, or Visco-3, are used in intra-articular injections for joint pain relief. They help by improving joint lubrication, reducing inflammation, and promoting tissue healing. Each dose is administered directly into the joint space.
206 services28 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
134 services96 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
82 services62 patients
Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose J7324
Orthovisc is a treatment involving injections of a substance called hyaluronan into your joints. Hyaluronan is a natural substance in your joint fluid that aids in movement and reduces pain. The Orthovisc injections help replenish this substance, relieving joint pain.
77 services13 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
68 services68 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85283 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ACHIEVE MORE SPORTS AND WELLNESS, PLLC
Clinic/Center (Primary Care)
6139 S RURAL RD STE 102
TEMPE, AZ 85283
Maricopa County (480) 846-0688

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Dault's NPI number?

The NPI number for Stacey Dault is 1760775357. It was assigned to this individual provider in the NPPES registry on May 16, 2011. The provider is also known as Dr. Stacey Louise Wetmore Do.

Where is Stacey Dault located?

Stacey Dault practices at 6139 S Rural Rd Ste 102, Tempe, AZ 85283. The listed phone number is (480) 846-0688.

What is Stacey Dault's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Stacey Dault enrolled in Medicare?

Yes. Stacey Dault is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Stacey Dault's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Stacey Dault reassigns Medicare benefits to 3 organizations: Achieve More Sports And Wellness, PLLC (Tempe, AZ), Modern Sports Medicine LLC (Tempe, AZ) and Scottsdale Health And Wellness PC (Scottsdale, AZ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Stacey Dault's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Stacey Dault was last updated on May 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.